Agreed standards and guidelines are the heart and soul of improving the differing training systems and to harmonize neurosurgical training in the European countries. Such standards and guidelines have been laid down in the European Training Charter of the European Union of Medical Specialists and recently novellated. This book, written by experienced neurosurgeons, offers all those concerned with neurosurgical training - trainers and trainees - practical advice to implement the above mentioned standards and recommendations. It has been written as a manual: "How to do it." It describes the tasks of a chairman (programme director), the tasks of the teaching staff, the organisation of a training curriculum, a rotation plan or a morbidity and mortality conference, the periodic progress evaluation, the course of an external audit and many more important topics. It contains a lot of practical tips, check lists and useful examples. Well educated young colleagues offer "safe neurosurgery" to our patients.

'Morphological imaging' and 'functional imaging' are current mainstays for the diagnosis, successful treatment and accurate follow-up of patients with endocrine disorders. Functional and Morphological Imaging of the Endocrine System provides the reader with comprehensive but concise insights in the application of cutting edge imaging techniques and updated imaging protocols for the diagnosis and treatment of hypersecretory hormonal syndromes and functional endocrine masses.

Imaging of Gastrointestinal Tract Tumors describes current imaging practice for the most commonly encountered benign and malignant digestive tract tumors and gives a review of the literature for less frequent tumors. General features (anatomic data, frequency, clinical and biologic signs, treatment) are discussed for all pathologies prior to description of imaging techniques, which include barium studies, ultrasonography and angiography, and above all CT. MRI appears particularly indicated for esophageal carcinoma and pelvic recurrences of colorectal cancers. The book is divided into three main section - benign tumors, malignant tumors, and tumors with an indeterminate prognosis - reflecting the value of different imaging strategies as a function of a tumor's natural history. The thorough analysis of literature for both frequent and less common tumors allows global evaluation of the diagnostic possibilities of imaging techniques, making Imaging of Gastrointestinal Tract Tumors a reference work for all specialists concerned with digestive tract pathologies.

Localization 1. C.S. Bosch, J.J.H. Ackerman, St. Louis, MO/USA SurfaceCoil Spectroscopy 2. P. Styles, Oxford, UK Rotating Frame Spectroscopyand Spectroscopic Imaging 3. P.A. Bottomley, Schenectady, NY/USA DepthResolved Surface Coil Spectroscopy (Dress) 4. R.J. Ordidge, J.A. Helpern, Detroit, MI/USA Image Guided Volume Selective Spectroscopy: A Comparison of Techniques for In-Vivo 31P NMR Spectroscopy of Human Brain 5. M. Decorps, D. Bourgeois, Grenoble, France Localized Spectroscopy Using Static Magnetic Field Gradients: Comparison of Techniques 6. J.A. den Hollander, P.R. Luyten, Ad J.H. Marien, Best, The Netherlands 1H NMR Spectroscopy and Spectroscopic Imaging of the Human Brain Spectral Editing and Kinetic Measurements 7. H.P. Hetherington, Birmingham, AL/USA Homo- and Heteronuclear Editing in Proton Spectroscopy 8. D. Freeman, R. Hurd, Fremont, CA/USA Metabolite Specific Methods Using Double Quantum Coherence Transfer Spectroscopy 9. B.A. Berkowitz, Research Triangle Park, NC/USA Two-Dimensional Correlated Spectroscopy In-Vivo 10. G. Navon, Tel Aviv, Israel; T. Kushnir, Tel Hashomer, Israel; N. Askenasy, O. Kaplan, Tel Aviv, Israel Two-Dimensional 31P-1H Correlation Spectroscopy in Intact Organs and Their Extracts 11. M. Rudin, A. Sauter, Basel, Switzerland Measurement of Reaction Rates In Vivo Using Magnetization Transfer Techniques

For the first time four crucial aspects of gastrointestinal endoscopy are combined in a single text. Drugs for sedation and monitoring of the patient are addressed with particular reference to safety issues and comfort and acceptability for the patient. Resource management and health economic techniques are applied to endoscopy to determine quality and outcome. Problems of negligence and informed consent form the basis of a medico-legal examination of endoscopic practices.

Isolated Cells and Perfused Organs 1. O. Kaplan, P.C.M. van Zijl, J.S. Cohen, Washington, DC/USA NMR Studies of Metabolism of Cells and Perfused Organs Individual Nuclei 2. S.R. Williams, London, UK In Vivo Proton Spectroscopy: Experimental Asoects and Potential 3. N. Beckmann, Basel, Switzerland In Vivo 13C Spectroscopy in Humans 4. M.J.W. Prior, R.J. Maxwell, J.R. Griffiths, London, UK Fluorine - 19F NMR Spectroscopy and Imaging In Vivo 5. J.S. Ingwall, Boston, MA/USA Measuring Cation Movements Across the Cell Wall Using NMR Spectroscopy: Sodium Movements in Striated Muscle 6. M. Rudin, A. Sauter, Basel, Switzerland In Vivo Phosphorus-31 NMR: Potential and Limitations

Historically the search for the neural bases of behavior goes back a long way. Neuroethology, which is concerned with the experimental analysis ofthe releasing and control mech anisms of behavior, is a young discipline. Results from this multidisciplinary branch of research, which uses physical, chemical, and mathematical methods, have not yet been extensively treated in textbooks of neurophysiology and ethology. This book is intended as a first attempt to pose major questions of neuroethology and to demonstrate, by means of selected research examples, some of the ways by which these questions are being approached. Inevitably this cannot be a complete and in depth detailed treatment of all of the neurobiology examples, and I realize that such a selection is of a subjective nature. The overall goal ofthe book is to present an introduction. After outlining some of the very basic neurophysiological and ethological concepts (Chaps. 2 and 3), neuroethological questions and methods are demonstrated extensively by means of a particular example (Chap. 4). There are two reasons to choose the visually guided prey-catching and avoidance behavior of the Common Toad: (1) it is a system which I have inves tigated for about fifteen years and therefore know best, (2) the toad story is one of the most comprehensive neuro ethological approaches so far. Thus, it is possible here to outline the major concepts of neuroethology and to pose the basic questions."

The purpose of this book is to provide some basic information regarding the fundamentals of magnetic resonance (MR) for all those who are less familiar with the technique and interested in MR spectroscopy and its possible applications in research and clinical practice. It will stimulate the reader to look more closely at the various topics covered by the contributors to this volume: tumor cell metabolism, kidney function, organ viability. Finally, several applications of high-field spectroscopy and imaging are illustrated. The book focusses on proven and possible clinical applications of MR in nephrourology: renal cell carcinoma, metabolic investigation of the kidney and pretransplant assessment of organ viability. The examples are thoroughly discussed and abundantly illustrated. The reader will benefit from this book by receiving a review of research and clinical aspects of MR simultaneously.

The series "Medical Radiology - Diagnostic Imaging and Radiation Oncology" is the successor to the well known "Encyclopedia of Medical RadiologyjHandbuch der medizinischen Radiologie." This international handbook with its unique compila tion of data in more than fifty volumes lags behind the fast developing knowledge in radiology today. "Medical Radiology" brings the state of the art on special topics in a timely fashion. The first volume of the series was "Lung cancer," edited by Scarantino. This volume "Innovation in Radiation Oncology," edited by H.R. Withers and L.J. Peters, presents data on the development of new therapeutic strategies in different oncologic diseases. 57 authors wrote 32 chapters covering a broad range of topics. The innovations are at various levels of development, but were all chosen with the practicing radiation oncologist in mind. Perhaps not all of the innovations will survive the test of time, others have now become well established standard procedure in some centers. Also discussed is the assessment of the effectiveness of standard treat ment and how it effects the quality of a patient's survival. The contributions have been grouped into 9 broad sections as outlined in the table of contents. We think the second volume, as the whole series, will provide valuable reading for the general community of radiation oncologists."

Der hier vorgelegte Atlas der Positronen-Emis- This atlas of positron emISSIOn tomography sions-Tomographie (PET) des Gehirns solI an- (PET) of the brain, with its many illustrations, hand von Bildbeispielen einen Uberblick tiber die is designed to give an overall impression of the Leistungsfahigkeit dieser aufwendigen Technik efficiency of this method in demonstrating physi- ologic and pathologic changes in the central ner- bei der Darstellung von physiologischen und vous system. In view of the rapid and multifa- pathologischen Veranderungen im Zentralner- vensystem vermitteln. Wegen der raschen und ceted development of PET, it seemed unrealistic vielseitigen Entwicklung der PET muBte von to attempt a comprehensive review of all the ap- vornherein auf Vollstandigkeit der Darstellung plications still in developmental or even in experi- aller in Entwicklung oder erster Erprobung be- mental stages. Attention has therefore been fo- findlicher Anwendungen verzichtet werden. Es cused on those methods which are already in rela- wurde daher ein Schwerpunkt auf die Methoden tively widespread clinical use and which are pro- gesetzt, die schon breiter klinisch angewandt wer- viding relevant findings on the pathogenesis and den und relevante Befunde tiber Pathogenese und development of diseases of the brain. Investiga- 15 Verlauf von Erkrankungen des Gehirns liefern.

A concise introduction to the principles and practice of point-of-care echocardiography for neonatologists Practical Neonatal Echocardiography is based on an acclaimed course that the authors havetaught for the past 15 years at USC training neonatologists in cardiac ultrasound ofneonatal patients for on-the-spot examination and diagnosis. Drs. Siassiand Noori have trained hundreds of physicians to use ultrasound equipment toexamine neonatal cardiac function at the first sign of distress, leading to fasterdiagnosis and referral to pediatric cardiologists for treatment. This book is designed to helpreaders develop the skills necessary to perform a high quality neonatalechocardiographic examination, evaluate cardiac function, and recognizeabnormalities and defects. Practical Neonatal Echocardiography begins with an introduction to the basic principles of echocardiography and the ultrasound scanners commonly used at pediatric cardiac centers. Neonatal cardiac anatomy is clearly described through the use of 2-dimensional images andvideo clips. Subsequent chapters teach the assessment of cardiac function, bloodflow, shunts, physical defects, and abnormalities that may exist in the absence of adefect. Myocardial dysfunction, heart failure, shock, hypertension, cardiomyopathy,cyanosis, and more are discussed in detail with multiple illustrative cases. *Integrated throughout the chapters are 110 video clips, which when looped, will display a beating heart. These real-life cases will help readers hone their skills in recognizing defects in cardiac function and growth.*Covers essential principles of echocardiography with clear descriptions and illustrations*Describes common features of ultrasound scanners and how to use them

In June 1989, a third conference concentrating on the progress in quantita tive coronary angiography and related techniques was held in Rotterdam, again very successful as the two preceding events in 1985 and 1987. Tech nical as well as clinical aspects of digital and digitized coronarography, morphometry, parametric imaging and functional quantification of the human coronary circulation were presented and discussed by prominent exponents of those groups who have been active in this particular field for many years. This book contains the chapters representing the lectures held by leading experts during the symposium that update the knowledge currently available, including most recent aspects in angioscopy and intravascular ultrasound imaging. It also includes a historical review on the development of angiogra phic techniques from the very early days on to our times given by one of the pioneers in heart catheterization and angiography, Dr. Kurt Amplatz. Those who had the chance to listen to his talk, will surely remember his impressive, humorous lecture as one of the highlights of this meeting."

Estimates reveal that there are some 200 million heterozygous carriers of abnormal hemoglobins genes worldwide, and tens of thousands of severely affected patients. Effective application of imaging techniques is essential to combat the continuing development of the disease and to ensure risk-free follow-up of the chronically ill. This is the first book to offer complete coverage of such radiologic applications with both conventional and the most modern imaging modalities. Interventional radiology, marrow transplantation, prenatal diagnosis by ultrasonography, and radiotherapy for bone marrow heterotopia are also featured.

These collected papers represent only a small part of the large amount of new work in the field of stereotaxy. The number of contributions to the Birmingham meeting was such that only selected papers, chosen as representative of advances in the field, could be printed. These papers present the most up to date accounts of major advances in stereotactic imaging and the renewed interest in the stereotactic treatment of movement disorders. Contents Section I. Stereotactic Imaging, Tumours and Haematomas Lipinski, H. G., Struppler, A., Birk, P.: Transformation Modes in Computerized Human Thalamic Brain Mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 3 . . . Giunta, F., Marini, G., Bertossi, M.: Stereotactic Computer Graphic System with Brain Maps. . ., 7 Giorgi, c., Cerchiari, U., Broggi, G., Contardi, N., Birk, P., Struppler, A: An Intraoperative Interactive Method to Monitor Stereotactic Functional Procedures . . . . . . . . . . . . . ., . . . 10 Giorgi, c., Cerchiari, u., Broggi, G., Passerini, A.: 3-D Reconstruction of Cerebral Angiography in Stereotactic Neurosurgery . . . . . . . . . . . . . . . . . . . . . . .. . . . 13 . . Vandermeulen, D., Suetens, P., Gybels, J., Oosteriinck, A: Angiographic Localizer Ring for the BRW Stereotactic System . . . . . . . . . . . . . . . . . . . . . . . . . ., . . 15 . . . Uematsu, S., Rosenbaum, A. E., Erozan, Y. S., Gupta, P. K., Moses, H., Nauta, H. J., Rigsby, W. H., Wang, A, Weiderman, L., Kumar, A J.: Intraoperative CT Monitoring During Stereotactic Brain Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 18 . . .

It is amazing to discover how little importance has been attached to narrow lumbar canal syndromes up to now. Though H. VERBIEST gave a very accurate description in 1949, the neurologist's and neurosurgeon's preoccupations were mainly focused on discal pathology, disregarding the problem of an exclusively bony origin in canalar stenosis. A. WACKENHEIM and E. BABIN have the merit of becoming aware of the impor tance and originality of this problem; they organized in the beautiful surround ings of the Bischenberg near Strasbourg, a postgraduate course, in which the most eminent European specialists in this field participated. I am very honored to have been asked to write the introduction to this mono graphy, which contains all the studies reported and commented on during this meeting. Before considering the problem from the various radiologic points of view, it is in my opinion indispensable to define the term "stenosis." We could not do so more accurately than by assuming the definition proposed by A. WACKENHEIM and E. BABIN and unanimously confirmed by all those who attented the session."

H.P. HIGER 1 In the seventeenth century people dreamed about a machine to get rid of evil spirits and obsessions, which were thought to be the main source of mis fortune and disease. I am not going to question this approach, because in a way it sounds reasonable. They dreamed of a machine that would display im ages from the inner world of men which could be easily identified and named. Somehow these are the roots of MR imaging. Of course, we now view disease from a different point of view but our objectives remain the same, namely to make diseases visible and to try to characterize them in order to cure them. This was the reason for setting up a symposium on tissue characterization. About 300 years later the clinical introduction of MRI has great potential for making this dream come true, and I hope that this symposium has con stituted another step toward its realization. When Damadian published his article in 1971 about differences in T1 relaxation times between healthy and pathological tissues, this was a milestone in tissue characterization. His results initiated intensive research in to MR imaging and tissue parameters. Actually his encouraging discovery was not only the first but also the last for a long time in the field of MR tissue characterization.

The development of magnetic resonance imaging (MRI) will deep ly change the relationship between neuroanatomy and the neuro logical sciences, particularly neuroradiology. Presentation of nor mal or abnormal brain structures is sometimes more precise in MRI sections than in brain or spinal-cord sections under macro scopic examination. It is our conviction that a better exchange be tween neuroanatomy and neuroradiology will improve knowledge of the brain. This international meeting held in Marseille, 26-27 September 1986 (under the Presidency of G. Lazorthes and G. Di Chiro in collaboration with M. Habib, secretary of redaction for the Congress and its publication) would like to contribute to this field. Marseilles, January 1988 A. Gouaze G. Salamon Table of Contents Introduction G. Lazorthes 1 External References of the Bicommissural Plane U. Bergva71, C. Rumeau, Y. Van Bunnen, J. M. Corbaz, and M. Morel. . . . . . . . . . . . . . . . . . . . . . . 2 Identification of Cortical Sulci and Gyri Using Magnetic Resonance Imaging: a Preliminary Study C. Rumeau, A. Gouaze, G. Salamon, J. LafJont, F. Gelbert, H. Einseidel, M. Jiddane, P. Farnarier, M. Habib, and S. Perot . 11 The Hippocampal Formation and Related Structures of the Limbic Lobe: Anatomic - Magnetic Resonance Correlation T. P. Naidich, D. L. Daniels, V. M. Haughton, A. Williams, P. Pech, K. Pojunas, and E. Palacios. . . . . . . . . . . . . 32 Brain Stem and Cerebellum: Normal and Pathological Anatomy C. M. Strother and C. Raybaud . . . . . . . . . . . . . . . . . 65 Magnetic Resonance Imaging of the Eyes and the Optic Pathways J. C. Tamraz, M. T. Iba Zizen, and E. A. Cabanis . . . . . . ."

The use of ultrasound for various diagnostic techniques in medicine continues to increase in popularity and complexity. It seems possible that the prediction of the National Science Foun dation that ultrasonic techniques may be used as frequently as X-ray techniques by the end of the decade may indeed be fulfilled. The annual scientific meeting of the American Institute of Ultra sound in Medicine is the only meeting held regularly on the North American continent and devoted solely to the diagnostic use of ultrasound. Under these circumstances it is not surprising to find that both the attendance at these meetings and the number of papers submitted for presentation, are increasing markedly each year. The papers presented at these meetings probably reflect the "state-of-the-Art" reasonably accurately. The Proceedings of these annual meetings are therefore a valuable record of the current state of ultrasonic diagnostic techniques in the U.S.A. Even though it is not possible to print in extenso every paper presented at the meeting, an attempt has been made with this volume, by increasing the length of the papers printed in abstract form, to enable the reader to obtain an overall view of current developments and research on this continent in all fields of ultrasonic medical diagnostic technology. Speed of publication is essential if this volume is to contain current information.

Magnetic resonance imaging became clinical in 1981 and since that time, has spread in the United States, Europe and Japan like wild fire. The tremendous advantages of the method consisting of safety, superb soft tissue contrast resolution, the ability to study flow, the ability to image in any plane or acquire data in 3D and an almost infinite array of sequences capable of distinguishing between disease and normal tissue, normal and abnormal blood flow make it incomparable for the diagnosis and study of multiple diseases and is particularly valuable in studying the heart and major vessels. The authors of this book have understood that the secret of success of MR imaging in the study of the heart is to combine the knowledge of anatomy of the heart, the coronary vessels, the pericardium and large vessels with the intricacies of MR imaging. This is why they go deeply into the basic principles of NMR, starting from the essentials and going then into detailed techniques of acquiring images from traditional spin echo to gradient echo and ultra fast imaging approaches, such as the multi shot and EPI. The flow phenomena are also discussed in detail from flow and magnetic field gradients diastolic pseudogating.

The key contribution of the approach to x-ray mammographic image analysis developed in this monograph is a representation of the non-fatty compressed breast tissue that we show can be derived from a single mammogram. The importance of the representation, called hint, is that it removes all those changes in the image that are due only to the particular imaging conditions (for example, the film speed or exposure time), leaving just the non-fatty interesting' tissue. Normalising images in this way enables them to be enhanced and matched, and regions in them to be classified more reliably, because unnecessary, distracting variations have been eliminated. Part I of the monograph develops a model-based approach to x-ray mammography, Part II shows how it can be put to work successfully on a range of clinically-important tasks, while Part III develops a model and exploits it for contrast-enhanced MRI mammography. The final chapter points the way forward in a number of promising areas of research. Audience: This book has been written for a wide readership, including medical image analysts, medical physicists, radiologists, breast surgeons, and research students. The mathematics and algorithms have been relegated to boxes so that the book can be read and understood even if the mathematical detail is skipped. Large parts of the monograph will be of interest to clinicians generally and to patients.

Since the introduction of myocardial perfusion imaging and radionuclide angiography in the mid-seventies, cardiovascular nuclear medicine has undergone an explosive growth. The use of nuclear cardiology techniques has become one of the cornerstones of the noninvasive assessment of coronary artery disease. In the past 15 years major steps have been made from visual analysis to quantitative analysis, from planar imaging to tomographic imaging, from detection of disease to prognosis, and from separate evaluations of perfusion, metabolism, and function to an integrated assessment of myocardial viability. In recent years many more advances have been made in cardiovascular nuclear imaging, such as the development of new imaging agents, reevaluation of existing procedures, and new clinical applications. This book describes the most recent developments in nuclear cardiology and also addresses new contrast agents in MRI. What's New in Cardiac Imaging will assist the clinical cardiologist, the cardiology fellow, the nuclear medicine physician, and the radiologist in understanding the most recent achievements in clinical cardiovascular nuclear imaging.

The imaging aspects of radiography have undergone con many sources and was in general freely given when requested siderable change in the last few years and as a teacher of and this is gratefully acknowledged. In particular I would radiography for many years I have often noticed the lack of a like to express my sincere thanks for help and information to comprehensive reference book for students. This book is an Mr J. Day of DuPont (UK) Ltd. particularly for the infor attempt to correct that situation and I hope this text will be mation and illustrations in the chapter on automated film of value not only to student radiographers but also prac handling; Mr D. Harper and Mr R. Black of Kodak Ltd. ; tising radiographers as well. Fujimex Ltd. ; CEA of Sweden; 3M (UK) Ltd. ; Wardray Much of the information is based on personal experiment Products Ltd. ; D. A. Pitman Ltd. ; Agfa-Gevaert; PSR Ltd. and the knowledge gained of students' difficulties in studying for their help with information on silver recovery, and this subject. I have attempted to gather together in one book Radiatron Ltd. for their help with safelighting. All were most all the information required to understand the fundamentals helpful in my many requests for information. of the subject both for examination and for practice. Some To Mrs A. Dalton and Mrs P.

Das vorliegende Buch enth{lt die Beitr{ge eines internatio- nalen Symposiumszum Thema "Stimulierte Hirndurchblutung." Vorgestellt werden zun{chst neue Erkenntnisse zur Regulation der Hinrdurchblutung. Im 2. Abschnitt kommen verschiedene Methoden zur Messung der Hirndurchblutung zur Sprache, die sowohl unter experimentellen als auch unter klinischen Be- dingungengetestet wurden. Es folgt ein Abschnitt, der ver- schiedene M-glichkeiten zur Stimulation der Hirndurchblutung aufzeigt. Im letzten Abschnitt wird aufdie Bedeutung der stimulierten Hirndurchblutungsmessung zur Bestimmung der ce- rebrovascul{ren Reservekapazit{ten hingewiesen. Dieser Para- meter hat nach den vorliegenden Untersuchungen klinisch- praktische Bedeutung, beispielsweise f}r die Indikations- stellung bei cerebrovascul{ren Eingriffen zur Isch{mie-Pro- phylaxe.

This book was conceived with the object of presenting to doctors and medical students with a potential interest in the disciplines of orthopaedic surgery, diagnostic radiology and orthopaedic pathology, a volume which would contain basic and essential information concerning those disorders of the skeleton in which a common interest exists. Diagnosis in such conditions is dependent on close collaboration between specialists in these subjects. As medical knowledge has advanced, so the necessity for detailed specialisation has increased. As a result co-operation in a combined approach has become of great importance. The method of presentation, in the form of Exercises, is designed to permit readers to test their own diagnostic ability. The book consists of ninety-four problems of diagnosis which might be encountered in any orthopaedic unit. The case material has been chosen to emphasise those conditions in which appreciation and integration of the clinical, radiological and pathological features are required in order to establish the diagnosis.